Edited by P. Syamasundar Rao .

364 pages .Open Access .

Congenital heart defect (CHD) may be defined as an anatomic malformation of the heart or great vessels which occurs during intrauterine development, irrespective of the age at presentation. Ventricular septal defect and coarctation of the aorta are typical examples of CHDs. The reported incidence of congenital cardiac defects varies between 0.6% and 0.8% of live births. This would result in the birth of 30 to 35,000 infants with CHD each year in the United States alone. Congenital heart defects are more common than well-known congenital anomalies such as congenital pyloric stenosis, cleft lip, Down syndrome, and congenital dislocation of the hip. Nearly 50% of these babies can be managed with simple medications, observation, and follow-up without any major therapeutic intervention. However, the remaining 50%, in the past, required surgical intervention, some under cardiopulmonary bypass. Since the advent of transcatheter techniques, 50% of these babies (i.e., 25% of the total) can be managed with less invasive, percutaneous, transcatheter techniques.

Developments such as early detection of the neonates with serious heart disease and their rapid transport to tertiary care centers, availability of highly sensitive noninvasive diagnostic tools, advances in neonatal care and anesthesia, progress in transcatheter interventional procedures, and extension of complicated surgical procedures to the neonate and infant have advanced to such a degree that almost all congenital cardiac defects can be diagnosed and “corrected”. The defects that could not be corrected could be effectively palliated. For achieving excellence in cardiac care, however, close interaction and collaboration of the pediatric cardiologists with neonatologists, pediatricians, general/family practitioners (who care for children with CHD), internists (who care for adults with CHD), anesthesiologists, and cardiac surgeons is mandatory. Education of physicians caring for children and adults with CHD continues to be important in achieving optimal care for the patients with heart disease.

Because of vastness of the subject, all issues related to congenital heart defects cannot be discussed in their entirety and therefore, only selected aspects will be included in this book. The book is divided into several sections, which include an overview of congenital heart defects, prevalence and etiology, some individual heart defects, management of some of the congenital heart defects, international issues, and miscellaneous issues. While there are significant advances in the understanding molecular mechanisms of cardiac development and of the etiology of CHD, these have not progressed to such a degree so as to be useful in preventing CHD at this time.